Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Jeremy Thayer, LICSW

Individual provider Clinical Social Worker · NPI 1518094846

Mr. Jeremy Thayer, LICSW is a Clinical Social Worker in North Kingstown, Rhode Island. Qualified in 2005, 21 years ago. Practices with Victa LLC, a 6-clinician group and accepts Medicare assignment. Licensed in Rhode Island.

Years since qualifying
21
Licensed in
RI
In the registry since
2007
Specialties on file
2
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

426 Scrabbletown Rd
North Kingstown, RI 02852-2001
Phone: (401) 829-3355
Fax: (401) 667-2733
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Social Worker (primary) Taxonomy 104100000X · Licence CSW00983 (RI)
Clinical Social Worker Taxonomy 1041C0700X · Licence ISW01934 (RI)

Record details

NPI number1518094846
Entity typeIndividual (Type 1)
GenderMale
Credentials LICSW
Sole proprietorYes
NPI enumeratedFebruary 27, 2007
Last updated in NPPESJune 13, 2022
Certification dateJune 13, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Victa Llc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in North Kingstown